The question Steve reports as well as the one Nancy states are both
reasonable questions.  While VA is committed to changing the infrastructure
of VistA (i.e. eliminating M) it is unlikely to be abrupt and will span at
least five to ten years.  Moving VistA to VistA-HealtheVet will certainly
have to incorporate interfaces between services and between applications and
services such that VistA/M as well as non-M components (services, apps, etc)
can continue to interoperate.  That means adopters outside VA may not have
to be in lockstep with VA for every application or service and can be
selective regarding a much wider range of components in VistA-HealtheVet
than can be easily done in today's VistA.  Those adopting VistA should
anticipate that updates will come with considerable regularity.  VistA has
had a history of gradual change (sometimes too gradual!) and progress
without huge disruptions to the sites has been a VistA hallmark (though some
might point out that even the introduction of CPRS was moderately
disruptive).  There should be a gradual migration with the inevitable
changes that come with the health care IT territory.  Helping others to keep
up with a core of service and interface specifications embodied in
VistA-HealtheVet is where the most important support must be focused.  While
I do not speak for VA, Centers for Medicare and Medicaid Services and
WorldVistA, there is considerable evidence that they (and others) have that
commitment.

The alternatives for adopters of healthcare IT is to either pick something
other than VistA (and there are many good choices) or wait for VA to
"finish" what it is building ... but that's like waiting for a city ... or
even a country to finish building ... Anyone who thinks that healthcare IT
can be "finished" will be in for a long wait.  Pick VistA, stay reasonably
close to the core (and even contribute to that core) and get on with IT.
The hardest part is starting.

Cameron

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Nancy
Anthracite
Sent: Monday, May 16, 2005 7:39 PM
To: [email protected]
Subject: Re: [Hardhats-members] vista reluctance

At an AMIA meeting,a year ago, I was asked the essentially rhetorical 
question,  "If the VA is getting rid of VistA because it is written in M, 
then why should anybody else be interested in it?" by docs who will admit to

never having laid eyes on VistA.  Apparently you have heard it, too. Makes 
you wonder where that question is coming from.   

On Monday 16 May 2005 06:09 pm, Kevin Toppenberg wrote:
> Well, this is kind of like asking the choir if they
> like to sing.
>
> But I have some personal experience with this.  I am a
> physician who has installed this myself in a multiple
> specialty group.  When I presenting the software to
> our group, the primary concerns were whether there was
> commercially available support (there is).
>
> To date, not many offices (that I know of) have
> implemented VistA.  I think this is because there is a
> learning curve.  We are all hoping that VistA office
> will address some of these issues when released by CMS
> later this year.
>
> But concerns about lack of support from the VA has not
> been an issue on my radar, or one that I have heard
> much about (regarding acceptibility of VistA)
>
> Kevin Toppenberg, MD
>
> --- [EMAIL PROTECTED] wrote:
> > Hi.
> >
> > Have you ever heard reports that some people are
> > reluctant to take up
> > vista outside the VA, not because of cost or
> > functionality, but because of
> > concerns that it will wither because the VA isn't
> > committed to it? I've
> > heard that as a general theroy, but if you know of
> > anyone specific, I'd
> > like to know that, or maybe something that is
> > discussed in the literature.
> > We are going to write a story this weekend about
> > vista use outside the VA.
> > If there are a lot of reluctant buyers that needs to
> > be reflected.
> >
> > Regards, Steve
>
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-- 
Nancy Anthracite


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